https://leader.pubs.asha.org/article.aspx?articleid=2478923Cultivating LeadershipA cooking enthusiast who harvests her own veggies, ASHA’s new president wants to grow members’ participation in the association’s work.2016-01-01T00:00:00FeaturesBridget Murray Law

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Features | January 01, 2016

Cultivating LeadershipA cooking enthusiast who harvests her own veggies, ASHA’s new president wants to grow members’ participation in the association’s work.

To hear her tell it, Jaynee Handelsman came to audiology via the “long route.” She changed her undergraduate major four times before settling on speech-language pathology. Then, after auditing a pediatric audiology class, she toured a state residential school for children with multiple impairments and suddenly envisioned herself being a pediatric audiologist.

“I thought about how you could connect with kids with such severe disabilities, and thought, ‘Man, I can see myself doing that!’”

So, after earning her master’s in audiology, Handelsman went on for her doctorate in speech-language pathology and audiology with an emphasis in audiology. Now, as ASHA’s 2016 president, she seeks to bring an audiology perspective to speech-language pathology, and vice versa.

Yes, she’s a voice for audiology—but more importantly, she says, she’s a voice for the type of interprofessional work that’s now essential for all health care-related fields, the professions and beyond.

Has your career so far been what you expected? Why or why not?

I started out as a pediatric audiologist and did that … for several years. Then I found a job in the VA in Ann Arbor. I was familiar to the VA system because I was a trainee at the Kansas City VA during my master’s and PhD programs. In the Ann Arbor VAMC job I developed a program with the University of Michigan to bring veterans to the university if they might be vestibular therapy candidates. So I morphed from working with kids to working with adults, and particularly to patients with dizziness and balance disorders.

I never expected my career to take that turn. Now after another turn, I’m back working with children as director of the pediatric audiology program at the University of Michigan’s C. S. Mott Children’s Hospital. So I’ve come full circle, again working with kids with hearing loss. And now I’m developing a pediatric vestibular program here because there’s a real need for that and I have that expertise.

Your research has focused on assessment and management of clients with dizziness and balance disorders and the impact of potentially ototoxic medications on hearing and vestibular function in children. Why this focus?

It was sort of an accidental thing. Early in my career, I really didn’t like testing dizzy patients because the testing is not particularly pleasant—they get dizzy, nauseated, so forth—and there weren’t many treatment options for them. However, when I was working at the VA in Ann Arbor, vestibular physical therapy was in its infancy. I had the opportunity to learn about it, as well as about newer evaluation options—including rotary chair and posturography—from Neil Shepard, who ran the University of Michigan Vestibular Testing Center. I really enjoyed it. Shortly thereafter I had the opportunity to oversee the balance program at Henry Ford Hospital (HFH) for seven years, including developing a vestibular therapy program. The ototoxicity interest happened while I was there.

At HFH, we started seeing patients with kidney disease who had bilateral vestibular losses after they were given gentamicin post-dialysis to prevent line infections. Gentamicin is an aminoglycoside antibiotic known to be toxic to the ear. There was a remarkable lack of awareness of the symptoms of vestibular loss among the physicians treating these patients, and the damage was done by the time the patients made it to us. So that’s what sparked my interest in monitoring for vestibular loss in patients receiving aminoglycosides.

Shortly after I came back to UM’s Vestibular Testing Center in 2000, we saw a teenage girl with cystic fibrosis who had developed a bilateral vestibular loss, and nobody on her treatment team recognized her symptoms. Patients with cystic fibrosis are frequently treated with inhaled and intravenous aminoglycosides. This patient had dizziness with every course of antibiotics. Because she recovered from a symptoms perspective, nobody believed they were real. She arrived in the clinic in a wheelchair, with her eyes closed. She couldn’t walk independently. This patient’s several bilateral vestibular loss gave me an inroad with the pulmonologists to talk about the vestibular system and ototoxicity. That caused us to change our clinical protocol patients with CF and to pursue a prospective study to look at prevalence of vestibular loss in children with cystic fibrosis being treated with aminoglycosides. We’re also looking at systematic changes in function over time with repeated exposures.

When you diagnose the vestibular loss, what can you do for these children since they have to be on these antibiotics?

Part of it is counseling. So back to the patient I mentioned: I explained to her important safety issues like the dangers of walking around in the dark, particularly on uneven surfaces or soft surfaces. I explained the need to avoid swimming in murky water. And vestibular physical therapy is very effective. You give them strategies to improve their function and help other systems compensate for the loss. Down the road I hope we can explore the use of protective agents: antioxidants for protection against hearing loss and vestibular loss, both from noise exposure and ototoxicity.

In patient care, you know you’re making a difference in people’s lives, and that’s a driving force behind what you do. But I don’t think we think about it as actively with the younger members of our profession who are watching us and being affected by us.

Moving on to your presidential term: You have a strong background in CSD leadership, having been audiology co-chair for the 2014 ASHA Convention, vice president for professional practice in audiology (2010–2012) and a member of the Board of Ethics. Why the interest in leadership and how will you fit in ASHA president on top of everything else you do?

When I was at HFH, I had the opportunity to get involved in volunteer leadership at the state level as well as with ASHA. My boss asked whether I would rather spend my allotted away time being involved at the state or national level, and I chose national. Once I got started with ASHA, I’ve been involved consistently. The volunteer experience I’ve had on all ASHA boards and committees has colored my personal and professional life in a way that nothing else has. Being on the Board of Ethics taught me about the value of sitting at the table, being prepared, voicing your opinions, listening to others, then making a decision and walking away from it with no animosity—such a great experience. When I started, I’d read case materials and think it was pretty straightforward. Then I’d listen to other people who had read exactly the same material and had a completely different take. That taught me why diverse perspectives are essential to making good decisions.

Every board and committee I’ve been on has taught me a lot about myself, others and leadership. I understand how the national office works, which is I think is really important if you’re going to be a volunteer leader. I’ve also spent a lot a time taking leadership development classes and working to improve my leadership skills. I don’t think I would have been ready to be president of ASHA without any of those things. It’s a big association, and it’s a lot of responsibility to be the volunteer face of it. I’m sure there’ll be moments that will be terrifying, but I know I’m up to the challenge.

What’s at the top of your presidential agenda?

In spite of our best efforts to connect with members (we ask for their opinion on a lot of things), we aren’t always as effective as maybe we could be at communicating back how their input influences the decisions that the board makes. So improving communication is important, as is achieving greater representation of groups like early-career professionals and men in volunteer leadership. The theme for the 2016 ASHA Convention is “everyday leadership; leadership every day,” inspired in part by a TED talk by Drew Dudley. So one thing I’d really like to see happen during my presidential year is that we move the bar a bit further in actively engaging folks who are not currently engaged but who would like to be.

Mentorship is key here. In patient care, you know you’re making a difference in people’s lives, and that’s a driving force behind what you do. But I don’t think that we think about it as proactively with the younger members of our profession who are watching us and being influenced by us. I’ve actively encouraged the audiologists who work with me to get involved professionally, either at the state or national level. I am happy to report that some have participated in ASHA’s Leadership Development Program and are excited to explore other ASHA leadership opportunities.

What are some big changes on the horizon in communication sciences and disorders that we need to prepare for?

The changes in service delivery and reimbursement models are huge and affect both professions in all settings, including schools. The move away from purely fee-for-service models in health care requires us all to carefully examine how we demonstrate the value of the services. The idea of people getting reimbursed based on the episode of care, quality of services and outcomes achieved is, in some ways, quite a radical shift. It’s hard to fully grasp all of the related changes that will affect our professions, but fortunately, ASHA has been preparing and communicating about these impending changes for some time now. Also important is practicing at the top of your license, which raises the issue of how we better use support personnel and other extenders of our services. Then there’s telepractice, which can be very useful—but it isn’t always clear how we can bill and how we can navigate the licensure issues across state and international borders. And another important issue on the horizon is interprofessional practice and interprofessional education. ASHA has teams working on all of these issues and I look forward to the progress that will be made during the next few years.

There is still confusion about what a interprofessional team truly is—it can include the patient, student or client along with their family and providers, who collectively develop a plan of care.

Speaking of education and training, what needs to change there?

The reality is that health care and school practice are moving rapidly toward fully integrated teams of providers. There is still confusion about what an interprofessional team truly is—it can include the patient, student or client along with their family and providers, who collectively develop a plan of care. Academic training programs may need to adjust so that they develop bridges across departments and disciplines. We need to figure out how to break down those historical barriers and get students used to working as part of a team.

We also need to get more involved with primary care in order to get primary care physicians to think about communication disorders—such as hearing loss or language impairments—that can be associated with comorbidities and cause unwanted, secondary consequences that might be avoided if detected and treated early on. For example, people with diabetes are more likely to have hearing and balance issues, so educating primary care physicians and encouraging them to refer individuals with diabetes to an audiologist just makes good sense.

We also need to help ensure that audiologists and SLPs who work in primary care settings are screening for hearing and speech and language disorders. A third thing, and ASHA is working on this as part of the Strategic Pathway to Excellence, is being able to document the value of our services. It’s not enough to do a patient satisfaction survey, which generally focuses on satisfaction with things like ease of getting appointments, parking availability and the services provided, but does not address the outcomes of care. We need to show how we fundamentally change the lives of patients and their families, which requires measuring outcomes, not just satisfaction with the experience of receiving services.

And now comes the fun part where you get to talk about some favorite ways to spend your (no doubt limited) spare time. So what do you enjoy?

I do pretty well with work/life balance. I’m a runner. I don’t run fast, but I do probably two half-marathons a year. I also love to cook. Part of the reason I run is so I can eat [laughs]. I cook pretty healthy meals most days that I’m home. We also grow vegetables; this year we had eight tomato plants, two kinds of kale, peppers, peas, beans, beets and chard. And I love baking bread—I make my own bagels when I have time. Cooking is really my creative outlet.

Also, we own a piece of property on the upper part of the Lower Peninsula of Michigan on Burt Lake, and we’re getting ready to build our planned retirement home on it. I’ve realized more as I’ve gotten older how much I love being on the water. I love big trees. I love the seasons. Our property is on the northeast side of the lake, so we’ll have sunsets. On a windy day, the lake gets waves on it. And it’s 100 feet of waterfront and three acres of wooded land. I don’t know how or why it is, but as you go up the Michigan peninsula, the sky gets bigger, and it’s just beautiful.

Also one of my absolute favorite things to do is to hang out with my husband, Keith. And it doesn’t even matter what we’re doing.

You have a son, too, right?

Yes. Trevor, who is 31. And Keith has two wonderful daughters who are in their 20s and working in New York City. Trevor is pursuing an acting career in Los Angeles. Probably the thing I feel most proud about is that despite my being a single parent for much of my adult life, Trevor is a compassionate and passionate human being who loves life.

Any final thoughts to share on the year ahead?

This is such a great opportunity. I’ve had great role models, and I’ve been paying close attention to them. A lot of people are excited about having an audiologist as president. It hasn’t happened in a long time. This will be a great opportunity for me to be the face of ASHA as an audiologist when I go to meetings of other audiology groups. That said, it’s important to me for the speech-language pathology members to recognize that I’m not only here to represent audiology. My goal is to help move things forward in all areas.

Day job: Director of pediatric audiology, C. S. Mott Children’s Hospital, and clinical assistant professor in the Department of Otolaryngology–Head and Neck Surgery, University of Michigan Health System

Passion: Moving the professions into the future through long-term vision and everyday leadership.